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multiple intramural uterine fibroids
Dr arpana mishra: multiple intramural uterine fibroids
Nov. 23, 2011 12:47 pm
i am unmarried and have multiple uterine fibroid for 8 yrs,but it was of small size i was asymptomatic.since 2 yrs its increasing in size.i am on norethisterone 5 mg tds for 11 mths.still spot bleeding every day is there.after every 2 mth i have to do blood tranfusion.till now i have done 4 transfusion.latest usg report is-8.6cm*6.5 cm the largest one ,second is 6.2*4.2cm ,third is 4.2*3.5 cm,ut is bulky.PA-ut is 14 wk size.kindly give your expert opinion.which lap surgeon in delhi should i consult???
Answer multiple intramural uterine fibroids Name Nehal Dalal
Dec. 13, 2014 10:43 pm
#19
Utdrus appears bulky 48X62X85mm and shown 14X18mm hypoechoic lesionin post. myometrium p/o fibroid cervis appears normal
et-12mm (Pl suggest that Removal of Uterus is necessary in this condition let me know on urgent basis please.
also let me know the bleeding is there since back 40 days can not stop back days

Dear Neha
Your USG shows uterus to be of normal size with a small fibroid. This fibroid looks innocent and for AUB i.e.(Altered uterine Bleeeding) you must consult a gynaecologist.

Thanks
With Regards
Dr J S Chowhan
Answer multiple intramural uterine fibroids Name Rama
Sep. 18, 2014 4:02 pm
#18
Age 50 yrs. unmarried. Periods irregular and very heavy. Doctor advised USG which showed multiple fibroids. Your advice.

Dear Rama
You are nearing the menopausal age with multiple fibroids and heavy bleeding. First line of treatment will be medical management with hormones etc. if it is not effective then surgery and Hystrectomy is recommended.

Thanks
With Regards
Dr J S chowhan
Answer multiple intramural uterine fibroids Name Mrs. Stella
Aug. 21, 2014 2:57 am
#17
I recently underwent a Examination at a Diagnostic Imaging Center in Mumbai/Bombay (India) and I am 55 years of Age and my periods has stopped 3 years back and do not have any bleeding.

My Recent Abdomen & Pelvic Sonography Report reads as under :

Liver is of normal size & echo texture. No evidence of focal lesion in Liver.
Portal vein appear normal (10MM) No dilated I.H.B.R.
No evidence of pleural effusion.

Gall Bladder is well distended. Tiny echogenic foci seen adherent to gall bladder wall suggestive of gall bladder polyps. No evidence of cholelithiasis.
No evidence of pericholecystic collection. No thickening of gall bladder wall.
C.B.D appears normal (2mm) and no evidence of calculi in it.

Pancreas shows normal echogenicity. No sign of acute or chronic Pancreatitis.
Spleen shows normal echogenicity and it is of normal size (8.5cms)
No evidence of Paraaortic Lymphadenopathy or Ascities.

Right kidney measures 9.0 with parenchymal thickness 1.7cms
Left Kidney measures 10.5cms with parenchymal thickness 1.9cms
No evidence of renal calculi or Hydronephrosis.
Mild fullness in both Kidney appear physiological .
Cortical echogenicity on either side appear normal.
Bladder shows smoth margin and there is no evidene of vesicle calculi.
Pre viod bladder volume is 605 cc. Post void residue of 27 cc.

" Uterus is normal in size and Retroverted in position, It measures 2.6cm in Transverse, 3.2 cm in AP and 7.7 cm in longitudinal axis. There is evidence of multiple intramural uterine fibroids, in the left Postero-lateral wall measring 4.2 x 3.5 cms, anterior wall measuring 0.7 x 0.5 cms and left lateral wall measuring 1.9 x 1.5cms. Endometrical canal is seen in the centre of the uterine cavity. Endometrial thickness measures 3mm.
Cervical canal shows no abnormality
Both the ovaries are of normal size.
Right ovary measure 1.9 x 1.0 cms. Left ovary measure 1.0 x 1.5 cms.
No evidence of adnexal mass. No evidence of fluid in posterior cul-de-sac is seen

Sonography examination of umbilical region was done using high frequency proble.
There is abdominal wall defect measureing 1.9 cms with protrusion of omental fat on coughing suggestive of umbilical hernia.

REMARK:

TINY GALL BLADDER POLYPS
RETROVERTTED UTERUS WITH MULTIPLE UTERINE FIBROIDS (4.2 X 3.5 CMS)
UMBILICAL HERNIA.
Report Signed by Doctor

Please let me know if this is uterus cancer and what special treatment is required from my side. I am shortly going for an " Umbilical Hernia " operation and Can I simultaneously get my self operated for my " RETROVERTED UTERUS WITH MULTIPLE UTERINE FIBROIDS (4.2 X 3.5 CMS) found as per the examination Report . Thanks for your reply. MRS. STELLA. K

Dear Madam

before deciding the treatment plan we want to know that your family is complete or not and what are the symptom you have at present. If your family is already complete you dont need to worry about these fibroids. After menopause the fibroid will shrink its own.

For polyp of gallbladder and umbilical hernia, both of them can be operated at same session and laparoscopic surgery would be the best option for this. We can perform your surgery at World Laparoscopy Hospital or you can chose any good laparoscopic surgeon nearby. Before surgery you need thorough evaluation by a gynecologist and a general surgeon. Please let us know if you want any further help.

With regards

Dr. R.K. Mishra


Answer multiple intramural uterine fibroids Name Babington Mary
Apr. 11, 2014 2:45 pm
#16
Kindly advise us on what to do as we married for 5 years.A pelvic scan test shows bulky uterus with AP diameter of 12.0cm.The echo pattern is heterogenous.The Myomtrium is expanded by intramural solid tissue masses with mixed echo textures and AP diametre of (1)5.3 cm in the mid Anterior wall (2)3.9cm in the fundal wall (3)5.8cm in the upper posterior will.No cyst,No pelvic collection.No cyesisor retained products of conception sighted.

Dear Babington Mary
The Laparoscopic Myomectomy is the treatment of choice for the intramural fibroids.please send scanned copy of ultrasound and MRI to advice further.

Thanks

With Regards

Dr J S Chowhan


World Laparoscopy Hospital
Cyber City, DLF Phase II, Gurgaon, NCR Delhi, 122 002, India
PHONES:
For Training: +91(0)9540993399, 9999677788
For Treatment: +91(0)9540994499
For General Enquiry: +91(0)124 - 2351555
Email: contact@laparoscopyhospital.com
Answer multiple intramural uterine fibroids Name xxxxx
Mar. 22, 2014 12:49 am
#15
the gall bladder is of normal shape and size. it shows normal wall thickness. NO calculus is detected in it.Two small echogenic foci are seen along the wall-polyps. what is the treatment for this? ??? the age of my mom is 43 years

Dear Harmanjot

The treatment for polyps in the gall bladder is Laparoscopic cholecystectomy.Before the surgery preanasthetic investigations and check up is done.

Thanks

With Regards

Dr J S Chowhan


World Laparoscopy Hospital
Cyber City, DLF Phase II, Gurgaon, NCR Delhi, 122 002, India
PHONES:
For Training: +91(0)9540993399, 9999677788
For Treatment: +91(0)9540994499
For General Enquiry: +91(0)124 - 2351555
Email: contact@laparoscopyhospital.com
Answer multiple intramural uterine fibroids Name Dosunmu Oluwakemi
Oct. 4, 2013 9:23 pm
#14
Dear Doc Chowhan,
How much does the UAE cost?

Laparoscopic Cholecystectomy fee also depends upon the type of room you opt.
Answer multiple intramural uterine fibroids Name megha
Sep. 16, 2013 9:14 pm
#13
a small hypo echoic fibroid size 8*5 mm in anterior myometrium treatment

Dear Megha

There will not be any consequence most of the time due to that much small fibroid.
Answer multiple intramural uterine fibroids Name ada
Aug. 15, 2013 4:29 pm
#12
I have multiple itramular fibrod what drugs do i use for it.

Dear Ada

You did not write your age and do you have baby or not. Most of the fibroid does not harm if your family is complete and if you don't have any symptom.

With regard

Sadhana
Answer multiple intramural uterine fibroids Name Mrs. Ametepey
May. 14, 2013 7:47 am
#11
I am 39 years diagnosed of intramural fibroid nodules and the centimetres are 2.9 x 2.4 x 2.4 cm and am afraid that with this I would get pregnant because i need a child badly.

do I have the chance

Dear Ametepey


Generally Small fibroids are not a cause of pregnancy and hopefully nothing should stop you to getting pregnant.

With regard

J S Chowhan
Answer multiple intramural uterine fibroids Name Annalakshmi
Mar. 30, 2013 5:44 am
#10
AUM SRI SAIRAM
TRANS ABDOMINAL SONOGRAPHY in June 2006
Uterus appeared bulky
Uterus measured 8.88 x 3.5 cms
Nebothian cyst in anterior wall
Left ovary appeared normal
Left ovary measured 2.6 x 2.0 cms
Right ovary appeared normal
Right ovary measured 3.4 x 1.8 cms
Right kidney appread normal
Right kidney measured 9.4 x 3.6 cms
Left kidney appeared normal
Left kidney measured 9.4 x 4.7 cms
IMPRESSION: BULKY UTERUS; NEBOTHIAN CYST IN ANTERIOR WALL; NORMAL OVARIES & KIDNEYS

FEB 2011 ULTRASOUND OF UTERUS:
Bulky uterus identified
Two fibroids measuring 15/16 mm and 20/19 mm were observed along the anterior wall
Myometrium appeared to be slightly mottled
Endometrium measured 12 mm
Answer multiple intramural uterine fibroids Name hadiza habia Haruna
Mar. 27, 2013 7:54 am
#9
I have a Multiple intramural fibroid
What is the treatment.
2. Can we a sex with my husband.
Answer multiple intramural uterine fibroids Name Bisbabe
Jan. 29, 2013 5:25 am
#8
I am married,in 2009 i had surgery for fibroid which does not affect my uterus. since then i have been trying to be pregnant and i have done series of hormonal test, pelvic scan, blood test etc and everyting was ok. last year december precisely 20th, i did another pelvic scan the result details are- THE UTERUS IS NON-GRAVID ANTEVERTED, OF NOMAL WITH NON-UNIFORM MYOMETRIAL ECHO-PATTERN. IT MEASURES ABOUT 50MM IN AP DIAMETER. THE ENDOMETRIAL WALL MEASURES ABOUT 8MM IN THICKNESS. THE RIGHT OVARY MEASURES ABOUT 36MM*27MM IN SIZE. THE LEFT OVARY MEASURES ABOUT 40MM*31MM IN SIZE. THERE ARE INTRAL MURAL FIBROIDS NOTED IN THE ANTERIOR AND POSTERIOR UTERINE WALLS. THE ANTERIOR ONES MEASURE ABOUT 15MM*14MM AND 15MM*15MM. THE POSTERIOR ONE MEASURE ABOUT 12MM*13MM IN SIZE. BOTH ADNEXAE ARE FEE BILATERIALLY, THE POUCH OF DOUGLAS IS FREE, THE GENERAL UTERINE OUTLINE IS INCONSISTENT.Pls i need your medical and economical solution to this problem because i want to have kids and i'm 40yrs plus. pls..........i want to be pregnant for God's sake!

Dear Bosbabe

After seeing your ultrasound report we want to advice you that fibroid is not creation problem to you. Most fibroids do not produce any symptoms. During a routine pelvic exam, in millions of women the first signs of fibroids can be detected. There are several tests that may show more information about fibroids but without any problem

With regards

Dr J S Chowhan
Answer multiple intramural uterine fibroids Name tracy
Jan. 27, 2013 7:26 am
#7
omg i am so worryed i have just read my letter it says i have a bulky uterus im on to my 4 misscaridge so does this mean i will never have kids r worse whats going to happen to me


Dear Tracy

It is not necessary that bulky uterus will not have capacity to become pregnent.
Please consult your gynecologist and get some more investigation done to rule out the causes of infirtility.

With regards

Sadhana
Answer multiple intramural uterine fibroids Name ann
Jan. 15, 2013 3:34 am
#6
I have two intramural uterine fibroids, one 7cm and the other 2cm. I am 40yrs unmarried. I have frequent urination and pelvic pressure, discomfort and constipation. Pl suggest, what type of laparoscopy surgery is required to remove it? can it be dissolved with medicines?


Dear Ann

Laparoscopic surgery is a good option for your fibroid to get removed. Some GNRH can work to srink the myoma but it again regrow once you will stop the treatment.

With regards

Sadhana
Answer multiple intramural uterine fibroids Name Hena mondal
Sep. 2, 2012 10:01 am
#5
Sir,

Many thanks for your valuable advice in response Q No-4.The doctor is emphasizing on Abdominal Hysterectomy as the fibroids became intramural and multiple as per TVS report if though it was single in hole abdomen U.S.G report which was done just one year before.Under this circumstances which advice will more preferable and safety? if Abdominal Hysterectomy necessity who can done safely plan Gyno/ Gyno M.S? plz. Plz.advice further once.

Dear Mondal

The choice is depend upon skill of gynecologists and the instrument available to perform the surgery. In case of multiple intramural myoma sometime we prefer da Vinci robotic surgery.

With regards
Dr J S Chowhan
Answer multiple intramural uterine fibroids Name Hena mondal
Aug. 30, 2012 9:06 pm
#4
I am now 49 years, my uterus was anteverted & bulky 12.o cmx6.4cmx6.2cm, with fundal sub serous hypo echoic lesion measuring 5.8 cmx4.8 cm, P.O.D Collection was 2.7 cn x2. 1 cm., No adnexal mass was there. U.S.G done on 18.08.2011, Then I was suffering from abdominal pain with diarrhea, chink pericardium effusion, Pleural effusion, hypothyroidism etc. During this period my menstruation period was going on with some irregular,

Hence my menstruation period has been stopped since after 11 th may 2012. then I had U.S.G., T V.S of lower abdomen, the size of uterus comes 10.2cn x 5.9 cm x6.6 cm with multiple varying sizes of intramural S.O.L ,S/O fibroids the largest one measure 4.1 cm x 3.0 cm. which are mild less in size than before. P.O.D No collection. Overies and cervix. appears normal At present I am feeling few frequent urination and pelvic pain only. Doctor Suggested Hysterectomy. What shall I do.

Dear Hena Mondal

At this age hysterectomy is required only if the symptom is due to fibroid because after menopause fibroid will start srinking. Uterine fibroid tumors or leiomyomas are estrogen dependent - they enjoy estrogen.

Actually, uterine fibroid tumors never develop prior to the start of menstruation when the female body begins producing estrogen. While pregnant, fibroid tumors often grow extremely fast due the additional estrogen produced by your body while pregnant.

Most women who've fibroid tumors and who are able to wait until after menopause discover their uterine fibroid tumors shrink and disappear once estrogen production stops in your body. Because of estrogen’s affect, both women who actually have fibroid tumors and people who've had uterine fibroids previously need to pay particular attention to the potential negative effects of estrogen-containing medications.

So in our opinion you should give more attention more on your thyroid problem rather than on your fibroid.

With regards
M.K. Gupta
Answer multiple intramural uterine fibroids Name Bulan
Aug. 15, 2012 9:57 pm
#3
Dear Sir, i am 49yrs. i had first U.S.G on july 2011 report was bulky uterus(12.0cm x6.4cmx6.2cm) with Fundal sub serous hypoechoic lesion(5.8cm x4.8cm) mensuration stopped during 3 (three) months before, U.S.G done rept.uterus ante-verted Size-L 10.2cm x5.9cm x6.6 cm with multiple varing sizes intramural S.O.L. S/O fibroid the largest one measure is 4.1 cmx 3.0 cm .endomerium not appriciated well. overies,P.O.D, U.B are normal. I have urging frequect urination,slite pain in pelvic area, no bleeding under this doctor adviced to go operation urgently what shall i do? operation may delay for few months....Anita

Dear Anita

Laparoscopic or robotic myomectomy is a good option for you, in which we or any of your surgeon accesses and removes fibroids via multiple, small abdominal incisions using specialized equipment. In some cases, this approach uses a surgical robot to perform the surgery.

With regards

M.K. Gupta
Answer multiple intramural uterine fibroids Name Dr JS Chauhan
Nov. 25, 2011 12:23 am
#2
Dear Dr Mishra

If you are interested we can perform laparoscopic or Robotic Myomectomy for you.

We frequently find that the records are quite different than what your surgeon find on evaluation, and that my recommendations is to get your self examined at World Laparoscopy Hospital and seeing you is totally different than we would have made from reviewing records alone.

With regards

JS Chowhan
Answer multiple intramural uterine fibroids Name Dr JS Chauhan
Nov. 25, 2011 12:20 am
#1
Dear Dr Arpana Mishra

We are veery sorry that you have such a problem created by multiple uterine fibroid. In our opinion you should either opt between laparoscopic myomectomy or uterine artery embolization. Because the effect of uterine fibroid embolization on fertility is not fully understood, UFE is typically offered to women who no longer wish to become pregnant or who want or need to avoid having a hysterectomy, which is the operation to remove the uterus.

Intramural fibroids are among the most typical types of uterine fibroids, present in 70% of women of childbearing age. Unlike subserosal fibroids, which develop on the exterior covering of the uterus, and submucosal fibroids, which develop just below the liner from the uterine cavity, intramural fibroids develop within the wall of the uterus.

Intramural fibroids begin as small nodules within the muscular wall of the uterus. As time passes, intramural fibroids may expand inwards, causing distortion and elongation from the uterine cavity. Sometimes these fibroid tumors may grow for the endometrial cavity being submucosal fibroids or they may even grow for the outer surface of the uterus to become subserosal fibroids.

Symptoms of Intramural Fibroids
Intramural fibroids are usually asymptomatic, but in some women, they might cause problems such as:

• Heavier menstrual bleeding
• Pelvic pain
• Pain in back and the back of the legs
• Constipation and bloating
• Constant urge to urinate
• Lower-abdominal pressure or heaviness due to the weight of large intramural fibroids
• Abnormally large abdomen
• Pain or discomfort during intercourse, if the fibroids can be found within the cervix area
• In some extreme cases, intramural fibroids may result in uterine hemorrhage

Intramural Fibroids and Infertility
Normally, intramural fibroids have no impact on fertility and pregnancy. However, within 3% of ladies, these uterine fibroids are linked with infertility. Ladies who have multiple intramural fibroids or large fibroids may find conceiving troublesome.

Intramural fibroids can prevent sperm from entering the uterine cavity, specially when the fibroids can be found in the cervix. These fibroids can also enlarge the uterine cavity, thereby increasing the distance that sperm have to visit get to the fallopian tubes. Additionally, intramural fibroids may affect the uterus’s ability to contract, which has a direct impact upon sperm migration and ovum transport.

Implantation of the embryo can also be inhibited by intramural fibroids as they distort the uterine cavity, impairing the circulation towards the endometrium and disturbing the endometrium structure. Even if implantation has occurred successfully, intramural fibroids may interfere with the introduction of the foetus.

Uterine fibroids usually enlarge as the pregnancy proceeds. Due to this, there's a tussle for space between the growing baby and also the intramural fibroids. This struggle may either induce developmental defects in the unborn child or could cause a miscarriage.

Management of Intramural Fibroids
If intramural fibroids aren’t disturbing a woman’s capability to conceive and aren’t causing any pain, chances are they will be left untouched. However, when the intramural fibroids are large, treatment may be essential to reduce the symptoms produced by them.

These uterine fibroids are generally treated by means of three kinds of surgical procedures:

1. Removal of one or more intramural fibroids by open abdominal surgery called abdominal myomectomy.
2. Destruction from the fibroids through uterine artery embolization by which polyvinyl alchol beads are injected in to the uterine artery with a catheter to bar the flow of blood towards the intramural fibroids
3. Hysterectomy which looks to get rid of the uterus

At the present time, effective medicines that may permanently shrink these fibroids aren't available. Hence, surgery is a option readily available for treating intramural fibroids. However, there is a new non-surgical solution that has allowed a large number of women worldwide to ensure that you eliminate their fibroids pain and other related symptoms within 12 hours as well as their intramural fibroids permanently within 2 months.

Uterine fibroid embolization (UFE) is really a minimally invasive treatment for fibroid tumors of the uterus. The process is also sometimes known as Uterine Artery Embolization (UAE), but this term is less specific and, as is going to be discussed below, UAE can be used for conditions apart from fibroids.

Fibroid tumors, also called myomas, are benign tumors that arise in the muscular wall of the uterus. It is very rare for them to turn cancerous. More commonly, they cause heavy menstrual bleeding, pain in the pelvic region, and pressure around the bladder or bowel.

Inside a UFE procedure, physicians make use of an x-ray camera called a fluoroscope to guide the delivery of small particles towards the uterus and fibroids. The small particles are injected through a thin, flexible tube called a catheter. These block the arteries that provide blood flow, causing the fibroids to contract. Nearly 90 % of ladies with fibroids experience relief of their symptoms.

If you are interested we can perform laparoscopic or Robotic Myomectomy for you.

We frequently find that the records are quite different than what your surgeon find on evaluation, and that my recommendations is to get your self examined at World Laparoscopy Hospital and seeing you is totally different than we would have made from reviewing records alone.

With regards

JS Chowhan

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